Urinary bladder amyloidosis

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Urinary bladder amyloidosis
Diagnosis in short

Urinary bladder amyloidosis. H&E stain.

Synonyms amyloidosis of the urinary bladder

LM lamina propria with amyloid (amorphous, paucicellular, pink material on H&E - classically "cracked")
LM DDx fibrosis, fibrin, leiomyoma
Stains Congo red +ve
Site urinary bladder

Prevalence very rare
Radiology thickened bladder wall
Clin. DDx other urinary bladder tumours - esp. malignant ones

Urinary bladder amyloidosis, more formally primary urinary bladder amyloidosis, is a rare benign condition of urinary bladder that can mimic cancer of the urinary bladder.[1]

General

Gross

  • Urinary bladder wall thickening.[1]

Microscopic

Features:

  • Lamina propria with amyloid.
    • Amyloid = amorphous, paucicellular material that is pink on H&E, classically has "cracked" appearance.
      • "Cracked": irregular fragments where the edges and centre of fragments are homogeneous.

DDx:

Images

Stains

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Urinary Bladder, Transurethral Resection:
- Urothelial mucosa with amyloidosis and mild chronic inflammation.
- Benign muscularis propria present.
- NEGATIVE for urothelial carcinoma in situ.
- NEGATIVE for evidence of malignancy.

Comment: 
Congo red staining and polarization confirm the presence of amyloid.

Primary bladder amyloidosis is rare; systemic causes of amyloidosis should 
be considered.

See also

References

  1. 1.0 1.1 1.2 1.3 Kobayashi, T.; Roberts, J.; Levine, J.; Degrado, J. (2014). "Primary bladder amyloidosis.". Intern Med 53 (21): 2511-3. PMID 25366012.
  2. 2.0 2.1 Schou-Jensen, KS.; Dahl, C.; Pilt, AP.; Azawi, NH. (Oct 2014). "Amyloidosis in the bladder: three cases with different appearance.". Scand J Urol 48 (5): 489-92. doi:10.3109/21681805.2014.920414. PMID 24857645.